fig20

Figure 20. Procedural guidance of Coronary Sinus Annuloplasty. After cannulation of the CS, a delivery catheter is positioned distal in the CS/GCV (A), as close as the antero-lateral commissure of the MV; quantitative venography (B) and pre-procedural CT allows for selection of the appropriate implant size. After deployment of the distal anchor of the device and application of manual traction, the proximal anchor is deployed (C); reduction of the septo-lateral dimensions and MR downgrading are finally assessed by fluoroscopy and color Doppler imaging: pre-procedural (D) and post-procedural MR (E). CS: coronary sinus; GCV: great coronary vein; CT: computed tomography; MV: mitral valve; MR: mitral regurgitation